Nurse clinic versus home delivery of evidence-based community leg ulcer care: A randomized health services trial

BACKGROUND: International studies report that nurse clinics improve healing rates for the leg ulcer population. However, these studies did not necessarily deliver similar standards of care based on evidence in the treatment venues (home and clinic). A rigorous evaluation of home versus clinic care is required to determine healing rates with equivalent care and establish the acceptability of clinic-delivered care. METHODS: Health Services RCT was conducted where mobile individuals were allocated to either home or nurse clinic for leg ulcer management. In both arms, care was delivered by specially trained nurses, following an evidence protocol. Primary outcome: 3-month healing rates. Secondary outcomes: durability of healing (recurrence), time free of ulcers, HRQL, satisfaction, resource use. Data were collected at base-line, every 3 months until healing occurred, with 1 year follow-up. Analysis was by intention to treat. RESULTS: 126 participants, 65 randomized to receive care in their homes, 61 to nurse-run clinics. No differences found between groups at baseline on socio-demographic, HRQL or clinical characteristics. mean age 69 years, 68% females, 84% English-speaking, half with previous episode of ulceration, 60% ulcers at inclusion < 5 cm(2 )for < 6 months. No differences in 3-month healing rates: clinic 58.3% compared to home care at 56.7% (p = 0.5) or in secondary outcomes. CONCLUSION: Our findings indicate that organization of care not the setting where care is delivered influences healing rates. Key factors are a system that supports delivery of evidence-based recommendations with care being provided by a trained nursing team resulting in equivalent healing rates, HRQL whether care is delivered in the home or in a community nurse-led clinic. TRIAL REGISTRATION: ClinicalTrials.gov Protocol Registration System: NCT0065638

Attraction of Egg Parasitoids Trissolcus mitsukurii and Trissolcus japonicus to the Chemical Cues of Halyomorpha halys and Nezara viridula

9openInternationalItalian coauthor/editorTrissolcus mitsukurii and Trissolcus japonicus are two Asian egg parasitoids associated with different pentatomids such as Halyomorpha halys. Adventive populations of T. mitsukurii were found in Northern Italy, suggesting its employment as a biological control agent (BCA) against H. halys. Nevertheless, to reduce the latter’s population, T. japonicus was released in Italy. Releasing an exotic parasitoid requires investigating the interaction between the BCA and the environment to avoid negative impacts on the entomofauna of the new habitat. Trissolcus mitsukurii is mainly associated with Nezara viridula in its native area. Therefore, we investigated and compared the ability of female T. mitsukurii and T. japonicus to distinguish between naturally released cues of H. halys and N. viridula. A single parasitoid was exposed to contact kairomones of both pests to evaluate its modifications in orthokinetic and locomotory behaviour. The behaviour of female T. mitsukurii was also tested on synthetic compounds simulating the cues of the two pentatomids. When naturally released cues were used, T. japonicus preferred the traces of H. halys, while T. mitsukurii preferred N. viridula’s cues. Moreover, the attraction of T. mitsukurii to N. viridula’s cues was confirmed with synthetic cues. Additional studies are needed to judge if this parasitoid can be used as a BCA.openScala, M.; Fouani, J.; Zapponi, L.; Mazzoni, V.; Wells, K.E.; Biondi, A.; Baser, N.; Verrastro, V.; Anfora, GScala, M.; Fouani, J.; Zapponi, L.; Mazzoni, V.; Wells, K.E.; Biondi, A.; Baser, N.; Verrastro, V.; Anfora, G

Ethnicity as a Moderator of Treatment Effects on Parent-Child Interaction for Children With ADHD

Objective: To examine ethnic differences in observed parenting and child behavior and the moderating effects of ethnicity on the relationship between treatment and parent and child behavior. Method: Observations of 508 children with ADHD (ages 7–9) and their caregivers, collected during the Multimodal Treatment Study of ADHD, were analyzed using univariate and mixed-model ANOVAs. Results: Although baseline parenting practices differed by ethnic group, ethnicity did not moderate the relationship between treatment and either parenting or child behavior. Conclusion: Consistent with data from normative samples, parents of children with ADHD differed by ethnicity in their utilization of certain parenting strategies. However, different ethnic groups did not differ on benefit received from treatments for ADHD, measured by parent and child behavior. Although ethnicity did not emerge as a moderator, ethnic minority family engagement in treatment may be increased by recognizing different parenting strategies and modifying interventions accordingly. (J. of Att. Dis. 2010; 13(6) 592-600

Volatilomics of raspberry fruit germplasm by combining chromatographic and direct-injection mass spectrometric techniques

The application of direct-injection mass spectrometric (DI-MS) techniques, like Proton Transfer Reaction Time of Flight Mass Spectrometry (PTR-ToF-MS) has been suggested as a reliable phenotyping tool for fruit volatilome assessment in both genetic and quality-related studies. In this study the complexity of raspberry aroma was investigated by a comprehensive untargeted VOC analysis, done by combining SPME-GC-MS and PTR-ToF-MS assessments with multi-block discriminant analysis using the DIABLO mixOmics framework. The aim was to acquire an exhaustive characterization of the raspberry volatilome according to different fruit ripening stages (pink, ripe, and overripe) and genetic variances (50 accessions), as well as to investigate the potential of PTR-ToF-MS as a rapid and high throughput VOC phenotyping tool to address issues related to raspberry fruit quality. Results of this study demonstrated the complementarity between SPME-GC-MS and PTR-ToF-MS techniques to evaluate the raspberry aroma composition. PTR-ToF-MS generates reliable raspberry VOC fingerprints mainly due to a reduced compound fragmentation and precise content estimation. In addition, the high collinearity between isomers of monoterpenes and norisoprenoids, discovered by GC analysis, reduces the main analytic limitation of PTR-ToF-MS of not being able to separate isomeric molecules. The high similarity between the VOC matrices obtained by applying PTR-ToF-MS and SPME-GC-MS confirmed the possibility of using PTR-ToF-MS as a reliable high throughput phenotyping tool for raspberry volatiolome assessment. In addition, results provided by the germplasm collection investigation enabled to distinguish the best performing accessions, based on VOCs composition, to be used as superior parental lines for future breeding programs

Onset of alcohol or substance use disorders following treatment for adolescent depression.

OBJECTIVE: This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD). METHOD: For 5 years, we followed 192 adolescents (56.2% female; 20.8% minority) who had participated in the Treatment for Adolescents with Depression Study (TADS; TADS Team, 2004) and who had no prior diagnoses of AUD or SUD. TADS initial treatments were cognitive behavior therapy (CBT), fluoxetine alone (FLX), the combination of CBT and FLX (COMB), or clinical management with pill placebo (PBO). We used both the original TADS treatment response rating and a more restrictive symptom count rating. During follow-up, diagnostic interviews were completed at 6- or 12-month intervals to assess onset of AUD or SUD as well as MDD recovery and recurrence. RESULTS: Achieving a positive response to MDD treatment was unrelated to subsequent AUD but predicted a lower rate of subsequent SUD, regardless of the measure of positive response (11.65% vs. 24.72%, or 10.0% vs. 24.5%, respectively). Type of initial MDD treatment was not related to either outcome. Prior to depression treatment, greater involvement with alcohol or drugs predicted later AUD or SUD, as did older age (for AUD) and more comorbid disorders (for SUD). Among those with recurrent MDD and AUD, AUD preceded MDD recurrence in 24 of 25 cases. CONCLUSION: Effective short-term adolescent depression treatment significantly reduces the rate of subsequent SUD but not AUD. Alcohol or drug use should be assessed prior to adolescent MDD treatment and monitored even after MDD recovery

Trauma history and depression predict incomplete adherence to antiretroviral therapies in a low income country.

As antiretroviral therapy (ART) for HIV becomes increasingly available in low and middle income countries (LMICs), understanding reasons for lack of adherence is critical to stemming the tide of infections and improving health. Understanding the effect of psychosocial experiences and mental health symptomatology on ART adherence can help maximize the benefit of expanded ART programs by indicating types of services, which could be offered in combination with HIV care. The Coping with HIV/AIDS in Tanzania (CHAT) study is a longitudinal cohort study in the Kilimanjaro Region that included randomly selected HIV-infected (HIV+) participants from two local hospital-based HIV clinics and four free-standing voluntary HIV counselling and testing sites. Baseline data were collected in 2008 and 2009; this paper used data from 36 month follow-up interviews (N = 468). Regression analyses were used to predict factors associated with incomplete self-reported adherence to ART. INCOMPLETE ART ADHERENCE WAS SIGNIFICANTLY MORE LIKELY TO BE REPORTED AMONGST PARTICIPANTS WHO EXPERIENCED A GREATER NUMBER OF CHILDHOOD TRAUMATIC EVENTS: sexual abuse prior to puberty and the death in childhood of an immediate family member not from suicide or homicide were significantly more likely in the non-adherent group and other negative childhood events trended toward being more likely. Those with incomplete adherence had higher depressive symptom severity and post-traumatic stress disorder (PTSD). In multivariable analyses, childhood trauma, depression, and financial sacrifice remained associated with incomplete adherence.\ud This is the first study to examine the effect of childhood trauma, depression and PTSD on HIV medication adherence in a low income country facing a significant burden of HIV. Allocating spending on HIV/AIDS toward integrating mental health services with HIV care is essential to the creation of systems that enhance medication adherence and maximize the potential of expanded antiretroviral access to improve health and reduce new infections

Resonant Cavity Perturbation: A Promising New Method for the Assessment of Total Body Water in Children

The accurate measurement of total body water (TBW) in children has important clinical and nutritional applications. Resonant cavity perturbation (RCP) is a new method for estimating TBW. This method measures the dielectric properties of the body which are related to body water. For RCP measurements, each subject lay supine on a bed inside a screened room which acts as a resonant cavity. A network analyser measures the frequencies of two low-order cavity resonances of the room, with electric-field vectors that were respectively vertical and horizontal, the resonant frequency shifts relative to the empty room are then derived. These frequency shifts correlates with TBW. The aims of this present study were to a) develop TBWRCP predictive equations for children using TBWdil as the criterion method, b) cross-validate the derived equations, c) determine precision of the TBWRCP method, and d) compare the criterion method TBWdil with three methods of estimating TBW: RCP, MFBIS and Anthropometry. Predictive equations, independent of sex, were developed with linear regression in a group of 36 children. The relationship between combined RCP frequency shifts and TBWdilution had an r2=0.90 and standard error of the estimate (SEE) =1.42kg. Multiple regression analysis, that included a term for body mass index, only had a small effect on r2=0.93 and SEE=1.25kg. In-vivo TBW precision for the vertical, horizontal and combined frequency modes ranged from 0.7 to 3.4%. Bland Altman analysis indicated close agreement between the criterion method TBWdil and the three other methods of TBW estimation. Mean differences were TBWRCP(2) = 0.01+/-1.34kg, TBWMFBIS = 0.45+/-1.35kg, TBWAnthropometry = 0.29+/-1.29kg. Currently the RCP method does not significantly improve the prediction of TBW compared to MFBIS and anthropometry in this initial study. However the derived equation was independent of sex and body size had only a small effect

A Review of Pink Salmon in the Pacific, Arctic, and Atlantic Oceans

The Northern Hemisphere Pink Salmon Expert Group Meeting was held on October 2–3, 2022 in Vancouver, Canada, immediately preceding the International Year of the Salmon (IYS) Synthesis Symposium. The rapid expansion of pink salmon was the theme for the meeting, and experts came together to discuss the current state of knowledge for pink salmon. Specific topics of focus included the range expansion into the Atlantic and Arctic oceans, trends in distribution and abundance, research and monitoring approaches, potential inter-specific interactions, mitigation efforts, and plans for future collaborations. The outcomes of the meeting were presented at the IYS Synthesis Symposium and are further disseminated through this NPAFC Technical Report. The Executive Summary section of this report provides a brief background, a condensed overview of each topic, and concludes with overarching takeaway messages that are intended to guide future collaborations.publishedVersio

A Review of Pink Salmon in the Pacific, Arctic, and Atlantic Oceans

The Northern Hemisphere Pink Salmon Expert Group Meeting was held on October 2–3, 2022 in Vancouver, Canada, immediately preceding the International Year of the Salmon (IYS) Synthesis Symposium. The rapid expansion of pink salmon was the theme for the meeting, and experts came together to discuss the current state of knowledge for pink salmon. Specific topics of focus included the range expansion into the Atlantic and Arctic oceans, trends in distribution and abundance, research and monitoring approaches, potential inter-specific interactions, mitigation efforts, and plans for future collaborations. The outcomes of the meeting were presented at the IYS Synthesis Symposium and are further disseminated through this NPAFC Technical Report. The Executive Summary section of this report provides a brief background, a condensed overview of each topic, and concludes with overarching takeaway messages that are intended to guide future collaborations.publishedVersio

DeLLITE Depression in late life: an intervention trial of exercise. Design and recruitment of a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Physical activity shows potential in combating the poor outcomes associated with depression in older people. Meta-analyses show gaps in the research with poor trial design compromising certainty in conclusions and few programmes showing sustained effects.</p> <p>Methods/design</p> <p>The Depression in Late Life: an Intervention Trial of Exercise (DeLLITE) is a 12 month randomised controlled trial of a physical activity intervention to increase functional status in people aged 75 years and older with depressive symptoms. The intervention involves an individualised activity programme based on goal setting and progression of difficulty of activities delivered by a trained nurse during 8 home visits over 6 months. The control group received time matched home visits to discuss social contacts and networks. Baseline, 6 and 12 months measures were assessed in face to face visits with the primary outcome being functional status (SPPB, NEADL). Secondary outcomes include depressive symptoms (Geriatric Depression Scale), quality of life (SF-36), physical activity (AHS Physical Activity Questionnaire) and falls (self report).</p> <p>Discussion</p> <p>Due to report in 2008 the DeLLITE study has recruited 70% of those eligible and tests the efficacy of a home based, goal setting physical activity programme in improving function, mood and quality of life in older people with depressive symptomatology. If successful in improving function and mood this trial could prove for the first time that there are long term health benefit of physical activity, independent of social activity, in this high risk group who consume excess health related costs.</p> <p>Trial registration</p> <p>Australian and New Zealand Clinical Trials Register ACTRN12605000475640</p